Our Summary

The study talks about three dogs that had chronic nasal issues and nosebleeds, which began over 100 days after they had brain surgery to treat brain tumors or a related condition. CT scans showed that all three dogs had severe inflammation and infection in their nasal passages and sinus, and tests confirmed that they had a fungal infection. The researchers found fungal growth on a mixture of bone and leftover surgical glue from the previous brain surgery in all three dogs. The fungus Aspergillus was found in all dogs, and another fungus, Chrysosporium, was also found in one dog.

The dogs were treated through surgery to remove the fungus and were given antifungal medicine either topically or orally. After treatment, the nasal issues improved temporarily but came back in all dogs about 100 days after the sinus surgery. One dog did not get further treatment, one dog was given oral antifungal medicine for an additional eight and a half months, and one dog had two more surgeries to remove the fungal growth. At the end of the study, two dogs were still alive, but one had to be put down due to severe seizures about 200 days after the sinus surgery.

The study concludes that a fungal infection in the sinus should be considered a possible complication in dogs that have persistent nasal issues, nosebleeds, and occasional sneezing after brain surgery. The causes of this complication could be many, and the researchers suggest that the use of surgical glue in the sinus during brain surgery should be further investigated as a potential risk factor.

FAQs

  1. What are the symptoms of sinonasal mycosis in dogs after transfrontal craniotomy?
  2. What treatments were used for the dogs with mycotic infection post-craniotomy in this study?
  3. What could be potential risk factors for developing sinonasal mycosis post-craniotomy in dogs?

Doctor’s Tip

One helpful tip a doctor might tell a patient about craniotomy is to be vigilant for signs of infection, such as persistent mucopurulent nasal discharge, intermittent epistaxis, and intermittent sneezing. If any of these symptoms develop, it is important to seek medical attention promptly to prevent complications like sinonasal mycosis.

Suitable For

Patients who are typically recommended craniotomy are those with intracranial tumors, vascular malformations, traumatic brain injuries, and other conditions that require surgical intervention to access and treat lesions within the brain.

Timeline

Before craniotomy:

  • Patient presents with symptoms such as chronic nasal discharge and epistaxis
  • Imaging studies (such as CT scans) are performed to diagnose the intracranial issue
  • Decision is made to undergo transfrontal craniotomy to treat the condition

After craniotomy:

  • Patient undergoes surgery to remove the intracranial lesion
  • Histologic examination and fungal culture are performed on samples obtained during surgery
  • Patient is diagnosed with mycotic infection in the frontal sinus
  • Surgical curettage and antifungal treatment are initiated
  • Nasal discharge improves initially but may recur in the following months
  • Additional treatments such as oral antifungal medication or surgical debridement may be necessary
  • Patient may experience complications such as status epilepticus and may require euthanasia
  • Long-term follow-up is required to monitor for recurrence or resolution of symptoms

What to Ask Your Doctor

  1. What are the potential risks and complications of a craniotomy procedure?
  2. How will my post-operative pain be managed?
  3. What is the expected recovery time following a craniotomy?
  4. How often will follow-up appointments be necessary after the procedure?
  5. What symptoms should I watch for that may indicate a complication or infection?
  6. Will I require any additional treatment or medications after the craniotomy?
  7. Are there any specific lifestyle changes or restrictions I should follow post-surgery?
  8. What is the likelihood of recurrence of the condition that necessitated the craniotomy?
  9. Are there any alternative treatment options to consider?
  10. What is the long-term prognosis for patients who undergo a craniotomy procedure?

Reference

Authors: Pilkington EJ, De Decker S, Mojarradi A, Rossanese M, Brockman DJ, Van den Steen N, Cahalan SD, Fenn JT. Journal: J Am Vet Med Assoc. 2022 Jan 4;260(6):643-649. doi: 10.2460/javma.21.03.0115. PMID: 34986118